Depressive moods

Au: Steger-W

So: Z. Allg. Med. 1985: vol61 pp 914-918

Description

• 93 patients were given either a mixture of valerian and hypericum (Sedariston) or the synthetic antidepressant Desipramine over 6 weeks.
• As measured by the CGI scale, the hypericum group was far superior to the Desipramine group after both 1, 3 and 6 weeks (see Figure11). The hypericum group increased its value from 1.0 to 1.9, while the Desipramine group lowered its value from 1.0 to 0.8.
• 70% of the patients in the trial group had a good or very good benefit-risk response while only 30% of the control group had a good response. The difference was highly statistically significant (p< 0.0004) (see figure 4).

D-S self-report scale on depression

The hypericum group lowered its value from 18 to 4, and the control group from 18 to 9. The difference was statistically significant (p=0.0239) (see Figure 5).

Physical complaint inventory (B-L according to von Zerssen)

• The hypericum group fell from a mean value of 25 at the beginning to 7 at the end.
• The Desipramine group fell from 27 at the beginning to 19 at the end.
• The difference was statistically significant at a value of p=0.0021.

Side effects

• A few patients experienced tiredness, vertigo, tachycardia and dry mouth.
• All side effects were mild and there were no significant differences between the two groups.
• The compliance was good and there where no dropouts because of ADRs.

Researchers' comments

The authors conclude that the combination of hypericum and Valeria is both more effective, better tolerated and has a faster effect than Desipramine.

Our comments

This study is interesting because it is the only one where a herbal combination (hypericum and valeria) has clearly bypassed a conventional antidepressant in terms of efficacy. The superior results of the herbal group over the control group in terms of scales using physical complaints (CGI, Bf-B) versus scales just measuring the psychic parameters (D-S) imply a much more benign side-effect profile as part of the reason for the superiority of the herbal remedy over the synthetic in this study.

The hypericum dose was very low compared to other studies (daily dose 0.20 mg hypericin, in other studies 0.75-2.7 mg daily).

In this study the combination herbal therapy also had a faster effect than the synthetic antidepressant. Most other studies have shown opposite tendencies (with a slower effect of hypericum). This might indicate a potentiating effect of hypericum and valerian. More studies are needed to investigate this, i.e., randomized controlled trials between valerian and hypericum and a combination of both.

The side effects were not well described in this study.